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Individual
KIMBERLY LYNN ANDERSON
Active
Individual
KIMBERLY LYNN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
17205
CA
363LF0000X
Family Nurse Practitioner
Primary
17205
CA
363LF0000X
Family Nurse Practitioner
30006873
WA
363LF0000X
Family Nurse Practitioner
5009812
NC
363LF0000X
Family Nurse Practitioner
910
AK
363LF0000X
Family Nurse Practitioner
AP117527
TX
363LP2300X
Primary Care Nurse Practitioner
AP117527
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023099
—
AK
01
—
12650825
CAQH
AK
01
—
17205
CALIFORNIA BON NURSE PRACTITIONER FURNISHER
CA
01
—
5009812
NC BON AUTHORIZATION TO PRESCRIBE
NC
01
—
9087
TEXAS BON RX AUTHORIZATION NUMBER
TX
01
—
AP117527
BON NURSE PRACTITIONER LICENSE
TX
01
—
AP30006873
WA STATE DEPARTMENT OF HEALTH ARNP LICENSE
WA
01
—
RN00151283
WA STATE DOH RN LICENSE
WA
Enumeration date
08/01/2006
Last updated
11/22/2024
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